机构：[1]Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Xihong Road 312, Fuzhou 350025, Fujian Province, People’s Republic of China.[2]Department of Hepatobiliary Surgery III, Eastern Hepatobiliary Surgery Hospital, Secondary Military Medical University, Shanghai, China.[3]Department of Hepatobiliary Surgery, The Affiliated Zhongda Hospital of Southeast University, Nanjing, China.[4]Department of Hepatobiliary Surgery, The Second Hospital Affiliated to Zhejiang University,Hangzhou, China.[5]Department of Hepatobiliary Surgery, The Southwest Hospital Affiliated to the Army Medical University, Chongqing, China.[6]Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.[7]Department of Hepatobiliary Surgery, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.华中科技大学同济医学院附属同济医院[8]Department of Hepatobiliary Surgery, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China.首都医科大学附属北京友谊医院[9]Department of Hepatobiliary Surgery, The West China Hospital of Sichuan University, Chengdu, China.[10]Department of Hepatobiliary Surgery, Renji Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.[11]Department of Hepatobiliary Surgery, Xuanwu Hospital Affiliated to Capital Medical University, Beijing, China.首都医科大学宣武医院[12]Department of Hepatobiliary Surgery, The Affiliated Hospital of Chuanbei Medical University, Nanchong, China.[13]Department of Hepatobiliary Surgery, Tiantan Hospital Affiliated to Capital Medical University, Beijing, China.首都医科大学附属天坛医院[14]Liver Diseases Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Background At present, hepatectomy is still the most common and effective treatment method for intrahepatic cholangiocarcinoma (ICC) patients. However, the postoperative prognosis is poor. Therefore, the prognostic factors for these patients require further exploration. Whether microvascular invasion (MVI) plays a crucial role in the prognosis of ICC patients is still unclear. Moreover, few studies have focused on preoperative predictions of MVI in ICC patients. Methods Clinicopathological data of 704 ICC patients after curative resection were retrospectively collected from 13 hospitals. Independent risk factors were identified by the Cox or logistic proportional hazards model. In addition, the survival curves of the MVI-positive and MVI-negative groups before and after matching were analyzed. Subsequently, 341 patients from a single center (Eastern Hepatobiliary Hospital) in the above multicenter retrospective cohort were used to construct a nomogram prediction model. Then, the model was evaluated by the index of concordance (C-Index) and the calibration curve. Results After propensity score matching (PSM), Child-Pugh grade and MVI were independent risk factors for overall survival (OS) in ICC patients after curative resection. Major hepatectomy and MVI were independent risk factors for recurrence-free survival (RFS). The survival curves of OS and RFS before and after PSM in the MVI-positive groups were significantly different compared with those in the MVI-negative groups. Multivariate logistic regression results demonstrated that age, gamma-glutamyl transpeptidase (GGT), and preoperative image tumor number were independent risk factors for the occurrence of MVI. Furthermore, the prediction model in the form of a nomogram was constructed, which showed good prediction ability for both the training (C-index = 0.7622) and validation (C-index = 0.7591) groups, and the calibration curve showed good consistency with reality. Conclusion MVI is an independent risk factor for the prognosis of ICC patients after curative resection. Age, GGT, and preoperative image tumor number were independent risk factors for the occurrence of MVI in ICC patients. The prediction model constructed further showed good predictive ability in both the training and validation groups with good consistency with reality.
基金：
This study was supported by Fujian provincial health research talent training
project (2019-1-85), Startup Fund for Scientific Research, Fujian Medical
University (2019QH1294), and Fuzhou Science and Technology Bureau project
(2020-WS-92).
第一作者机构：[1]Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Xihong Road 312, Fuzhou 350025, Fujian Province, People’s Republic of China.
共同第一作者：
通讯作者：
通讯机构：[1]Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Xihong Road 312, Fuzhou 350025, Fujian Province, People’s Republic of China.[14]Liver Diseases Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
推荐引用方式(GB/T 7714)：
Yifan Chen,Hongzhi Liu,Jinyu Zhang,et al.Prognostic value and predication model of microvascular invasion in patients with intrahepatic cholangiocarcinoma: a multicenter study from China[J].BMC CANCER.2021,21(1):doi:10.1186/s12885-021-09035-5.
APA：
Yifan Chen,Hongzhi Liu,Jinyu Zhang,Yijun Wu,Weiping Zhou...&Jingfeng Liu.(2021).Prognostic value and predication model of microvascular invasion in patients with intrahepatic cholangiocarcinoma: a multicenter study from China.BMC CANCER,21,(1)
MLA：
Yifan Chen,et al."Prognostic value and predication model of microvascular invasion in patients with intrahepatic cholangiocarcinoma: a multicenter study from China".BMC CANCER 21..1(2021)
医学